ENABLING FUNCTIONAL ABILITY

Optimizing functional ability toward a decade of healthy ageing for individuals will require policies, systems and services that understand and optimize trajectories of ability across the life course. At a population level, dynamic strategies are necessary to not only aim to raise overall levels of ability but to paying particular attention to those subpopulations with the least resources or lowest level of functional ability.

The interaction between the physical and mental capacities of a person (intrinsic capacity) with their surrounding environment (the external world) is highly influential in determining level of functioning and ability to contribute to society.

Today most information on intrinsic capacity comes from research into the period of life when significant losses in functioning are being experienced, often through the measurement of activities of daily living (ADLs) or instrumental activities of daily living (IADLs). These measures can be useful in identifying the need for social care, and in some longitudinal studies for identifying the predictive value of individual conditions or groups of conditions on functioning more broadly or on future care dependence. However, these measures are also limited to identifying people with serious losses of functioning and what is missing from the body of evidence is guidance on the trajectory that may have preceded these significant losses of function or the factors that may have influenced it.

Physical and social environments are powerful influences on health ageing and shape the trajectories of capacity to extend what a person is able to do (their functional ability). Age-friendly environments facilitate older people to be and to do what they have reason to value by enabling them to maximize both their capacity and their ability.

Creating environments that are truly age-friendly requires action across all sectors including; health, long-term care, transport, housing, labour, social protection, industry, information and communication. It also requires action at multiple levels of government and across the private and corporate sectors. Aiming towards the shared goal of optimizing functional ability allows these different stake holders to work within their core areas but in a focused way that complements what is being done by others.

To enable society to render health and social policy to ensure individuals are equipped to pursue their goals and achieve their full potential in life, new thinking and emerging technology must be embraced when looking at functional ability. For example:

Reablement is part of this new policy narrative and challenges the negative discourse of ageing and age-related morbidities towards a perspective which focuses on intrinsic capacity and functional ability.

The emerging field of cognitive ageing and cognitive reserve, while complex is a critical policy area requiring a systematic and coherent evidence-based response from stakeholders across sectors and across disciplines. Finding ways that mitigate cognitive ageing and severe cognitive deterioration is imperative and today is a global public health concern.

The growing body of literature of human-animal studies highlights the importance of the human-animal bond and the increasing evidence of the health and social benefits of companion animals-benefits of companion animals.